Organization
EXTENSION HOME HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANEKA WALKER NP-C (OWNER)
(937) 522-1752
Entity
Organization
Contact information
Practice address
5101 CRESTWATER DR, MANSFIELD, TX 76063-6842
(937) 522-1752
Mailing address
PO BOX 1441, MANSFIELD, TX 76063-1441
(937) 522-1752
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/17/2014
Last updated
10/17/2014
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